Could rheumatoid arthritis be treated with an
antibiotic for periodontal infections? Dr. Walter Bretz, an Associate Professor of Cariology & Comprehensive Care, is partnering with researchers at the NYU School of Medicine to address this question in a new study funded by a two-year, $4 million grant from the NIH/ National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Rheumatoid arthritis, a form of chronic arthritis
characterized by painful and swollen joints, stiffness, and fatigue, occurs when the body mistakenly mounts an immune defense against its own cells. Although past research suggests that oral and intestinal pathogens
produce enzymes that alter the immune system and cause it to produce inflammatory substances that attack the joints, questions remain about the identity of those bacteria and their role in rheumatoid arthritis.
Dr. Bretz will compare oral bacteria in 90 subjects with early-stage rheumatoid arthritis against 30 healthy subjects and 30 subjects with early-stage psoriasis - another autoimmune system disorder. Dr. Bretz and the study's principal investigator, Dr. Steven B. Abramson, a Professor of Medicine and Pathology and Director of the NYU Division of Rheumatology, will then identify the 300 oral and intestinal bacteria most common to rheumatoid arthritis subjects, establishing genetic markers for those at risk for the disease. The researchers will also observe how oral and intestinal microbes contribute to the development of rheumatoid arthritis in laboratory mice, and will administer doxycycline and vancomycin, antibiotics that kill periodontal and
intestinal bacteria, respectively, to two separate groups of human rheumatoid arthritis subjects. If both drugs prove successful in reversing the course of the disease, they could be jointly administered in a future clinical trial.
Dr. Bretz's coinvestigators are Dr. Yvonne Buischi, a periodontist and Research Scientist in Cariology & Comprehensive Care, and Dr. Patricia Corby, Assistant Professor of Periodontology and Implant Dentistry and Assistant Director of the Bluestone Center for Clinical Research, both at NYUCD. Additional coinvestigators include Dr. Jose U. Scher, Instructor of Medicine and Rheumatology at the NYU Hospital for Joint Diseases; Dr. Dan Littman, Kimmel Professor of Molecular Immunology and Professor of Pathology and Microbiology at the NYU Skirball Institute of Biomolecular Medicine; and Dr. Gerald Weissmann, Professor Emeritus of Medicine, NYU School of Medicine.